Utility of Effusion Cytology and Image Analysis in the Diagnosis of Mesothelioma

描述（由申请人提供）：间皮瘤是一种罕见但通常致命的疾病，通常与接触石棉有关。恶性间皮瘤与良性间皮瘤增生的鉴别通常是通过活检标本的组织学检查来评估组织浸润性。胸腔积液（肺和胸壁之间的液体）细胞学检查通常是一种侵入性较小的程序，大多数医院都可以提供。由于无法评估组织侵袭性，从细胞学标本中诊断这种恶性肿瘤往往是不可能的。我们的提案详细介绍了一个试点项目，该项目将与西宾夕法尼亚卫生系统病理学和实验室医学系统主席（Jan F. Silverman，医学博士）以及克利夫兰诊所的解剖病理学医学主任（Tarik M. Elsheikh，医学博士）合作进行，以测试卡内基梅隆大学（CMU） Rohde博士实验室最近开发的一种图像分析方法，该方法可直接从胸腔积液细胞学中检测癌症。将Dr. Rohde的方法应用于Dr. Silverman提供的数据（详见申请书）的初步结果表明，该方法可用于恶性间皮瘤的诊断。这项初步研究的目的是测试Rohde博士实验室开发的方法在区分恶性间皮瘤和良性间皮瘤增殖方面的准确性，直接从积液细胞学中区分两种患者

DESCRIPTION (provided by applicant): Mesothelioma is a rare though often fatal disease, often associated with exposure to asbestos. The differentiation of malignant mesothelioma from benign mesothelial proliferation is often achieved by assessing tissue invasiveness from histological examination of biopsy specimens. Pleural effusion (fluid between lung and the chest wall) cytology is often a less invasive procedure that can be made available in most hospitals. Diagnosis of this malignancy from cytology specimens is often not possible, given that tissue invasiveness cannot be assessed. Our proposal details a pilot project to be conducted in collaboration with the System Chair of Pathology and Laboratory Medicine of Western Pennsylvania Health System (Jan F. Silverman, M.D.), as well as the Anatomic Pathology Medical Director of the Cleveland Clinic (Tarik M. Elsheikh, M.D.) to test an image analysis approach most recently developed by Dr. Rohde's laboratory at Carnegie Mellon University (CMU) for cancer detection directly from pleural effusion cytology. Preliminary results resulting from the application of Dr. Rohde's methods to data provided by Dr. Silverman (detailed in the application) indicates the method can potentially be useful for diagnosis of malignant mesothelioma. The objective of the pilot study would be to test the accuracy of the method developed by Dr. Rohde's laboratory in differentiating malignant mesothelioma from benign mesothelial proliferation directly from effusion cytology with a larger cohort of patients from two institutions (WPAHS and CC). If successful, the completion of the project could have a significant impact in reducing overall costs and avoiding health risks associated with invasive procedures. The successful completion of this project could also pave the way for the application of similar techniques on several similar cytopathology diagnostic and prognostic challenges.